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Why is biologic therapy useful in spondyloarthritis? Knowledge from synovial immunopathologic studies of spondyloarthritis
Author(s) -
Chou ChungTei
Publication year - 2012
Publication title -
international journal of rheumatic diseases
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.795
H-Index - 41
eISSN - 1756-185X
pISSN - 1756-1841
DOI - 10.1111/1756-185x.12006
Subject(s) - medicine , rheumatoid arthritis , synovitis , vascularity , hyperplasia , osteoarthritis , arthritis , inflammation , tumor necrosis factor alpha , secukinumab , synovial membrane , etanercept , pathogenesis , pathology , immunology , psoriatic arthritis , alternative medicine
The pathogenesis of most rheumatic diseases remains unknown. It is believed that both genetic and environmental factors play a pivotal role in the development of synovial inflammation in rheumatoid arthritis ( RA ), spondyloarthritis ( S p A ) and osteoarthritis ( OA ). In the last two decades, there have been many immunopathologic studies on RA , S p A and OA , and the findings revealed different types of arthritis may also present different pathologic patterns. These included higher vascularity and increased infiltration with CD 163 macrophages and neutrophils, but relatively low values for lining cell ( LL ) hyperplasia in S p A synovium. However, the increased LL hyperplasia, as well as CD 1a+ cells and the presence of intracellular citrullinated protein were more prominent in RA than in S p A synovitis. Anti‐tumor necrosis factor alpha (anti‐ TNF α) therapy can significantly reduce synovial LL hyperplasia, vascularity and mononuclear cells infiltration in the majority of RA or S p A patients. This may explain why clinically, arthritis patients can get significant improvement after TNF α blocker treatment.